Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure for examining the moral (...) dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships. (shrink)

It is clear that in the eyes of a growing number of humanitarian fieldworkers and decision-makers, palliative care is something humanitarian organizations should strive to provide as they address the needs of populations affected by crises. What remains less clear are the moral justifications underlying the push to do so. This chapter dives beneath surface prescriptions of what “ought to be” the place of palliative care within humanitarian response. It presents and analyses a series of evocative statements made by 24 (...) humanitarian healthcare actors about why, on what bases, and with what caveats, care for the dying deserves more attention within humanitarian healthcare response. Embedded in these statements are sometimes explicit, sometimes implicit ideas about what it means be a human and a humanitarian, and what humans need and deserve. Clarifying the experiences, practical considerations, understandings of care and responsibility, and norms and values underlying these feelings renders these available for more thorough reflection, discussion, and debate. (shrink)

This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations. In the narratives, not treating the patient(s) was sometimes understood as the right thing to do, and sometimes as wrong. In analyzing participants’ narratives we draw attention to how medications and equipment are represented. In one type of narrative, medications and equipment are represented primarily as scarce resources; in another, they are (...) represented as patient care. In the contexts respondents were working, medications and equipment were often both patient care interventions and scarce resources. The analytic point is that health professionals tend to emphasize one conceptualization over the other in coming to assert that not treating is right, or wrong. Rendering tacit ethical frameworks more explicit makes them available for reflection and debate. (shrink)

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure for examining the moral (...) dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships. (shrink)

Health care professionals who travel from their home countries to participate in humanitarian assistance or development work experience distinctive ethical challenges in providing care and services to populations affected by war, disaster or deprivation. Limited information is available about organizational practices related to preparation and support for health professionals working with non-governmental organizations. In this article, we present one component of the results of a qualitative study conducted with 20 Canadian health care professionals who participated in international aid work. The (...) findings reported here relate to expatriate clinicians’ experiences and perceptions of ethics preparation, training and support. The strategies examined include pre-departure training and preparation, in-field supports and retrospective debriefing of ethical issues. Participants experienced a range of training and supports as beneficial for addressing ethical challenges in humanitarian assistance and development work. Participants also expressed ambivalence or scepticism about the benefits offered by specific modalities. This analysis can contribute to informing discussions of how organizations and individual practitioners can best develop, implement and utilize ethics training and support for international aid work. (shrink)

At IAPS Ljubljana conference (September 2007) Dag Vidar Hanstad and Sigmund Loland presented a paper on elite-level athletes' duty to provide information on their whereabouts, to decide between two opposing positions: is this WADA demand justifiable anti-doping work or an indefensible surveillance regime? They concluded that on moral grounds this regime is conditionally acceptable, the condition being the acceptability of a general framework and objectives embodied in anti-doping global legislative foundations (the World Anti-Doping Code). But, as they said, principled (...) objections against the system have more universal relevance, which has to be taken seriously . To take this ambiguous and intriguing conclusion a step further, I propose a legal rather than ethical approach, from the aspect of constitutional and international human rights law, and the possible clash of two legally acknowledged values - the concept of elite sport without doping, and the concept of individual human rights. This conflict between ideological or moral values and the legality of individual rights is not a novelty. This paper presents three instances of this conflict: Bernard de Mandeville's differentiation between public and private values; Eug ne Sue's parallel legal and civil morals; and the contemporary moralisation of law which conflates legality into morality. The subordination of legality to morality has potentially dangerous consequences: here, Agamben's 'state of exception' comes to mind, with his analysis of potestas and auctoritas. However, in the case of sport and the war against doping, the origin of power is not in the nation state; it originates in civil society's non-governmental national and international bodies recognised as autonomous sources of legal order. (shrink)

Designed as a textbook for courses in political theory, political sociology and comparative politics, and as a contribution in its own right, this book explores the role of elite relations as a key to understanding democracy. Following a critical review of the literature on classes, democracy and elites, the author argues that although Western democracy is not `governed by the people' and has not created equality, it is unique in that it has generated a relative separation of power holders, (...) or a relative autonomy of elites and sub-elites in the control of resources. Developing this argument the author discloses strengths and weaknesses in democracy's infrastructure. The Elite Connection contains a warning that a major danger to democracy stems from the tendency of elites to make incursions into the autonomy of other elites, and to develop excessively close dependency relations, either in subjugation of them, or in collusion with them, which result in threats to civil liberties and to the very foundations of democracy. It argues, however, that democracy has the built-in potential to counter its own subversions. Although it focuses on elites, the book has an egalitarian perspective: it concludes with the argument that the separation of elites makes possible struggles for greater equality. The still relatively independent elites of social movements have the potential of pushing democracy towards greater participation and equality. (shrink)

In the world of elite sport, pain and suffering are inherent. In exploring return-to-play treatments and decision-making in sports medicine, two overarching areas seem to dominate the existing lite...

Researchers have studied the athletes' dual careers with the aim of helping them to combine the sport and the academic–vocational sphere. Most of this research has addressed the study–sport combination, but there is a lack of studies on the work–sport combination. The main objective of this research was to explore the subjective perceptions of Spanish elite athletes when attempting to combine their careers as professional athletes with a second profession or trade. Further, this study aims to identify the access (...) to facilitating resources and the perception of obstacles and barriers to the development of a dual career. A qualitative approach was chosen to address these research questions. Interpretative phenomenological analysis was carried out on a sample of 18 elite athletes, and the data were collected using semi-structured interviews based on a set of superordinate and subordinate categories. The results showed that the athletes interviewed possessed valuable resources such as the transference of sports values to the work sphere. However, important barriers were highlighted such as the perception of sport institutions as absent entities in the work–sport combination. Thus, the study of this type of dual career seems to be one of the challenges facing the interested scientific community for the coming years. (shrink)

Journal of Political Philosophy, EarlyView.

Recent political developments leave liberal elites heartbroken. Why is it that the masses keep making poor, morally unacceptable, irrational choices? Among the many voices heard in this context, there are also those criticising those elites from the left. The elites, these voices imply, are guilty not just of past wrongs that have gotten us here, but also of patronising the masses right now, arrogantly failing to take seriously the masses and their concerns. I argue that such complaints – perhaps appearances (...) to the contrary notwithstanding – are every bit as patronising in their attitudes towards the masses they claim to respect, and proceed to discuss the question whether the elites should reason with the masses, or manage them. This practical discussion leads to more theoretical ones about justification and excuse in the public sphere, practical and epistemic reasons for belief, and ideal and non-ideal theory in political philosophy. (shrink)

The rhetorical tradition has long been concerned with how to negotiate the discursive juncture between mass and elite audiences. Such a concern has contributed to what might be characterized as the rhetorical tradition's anxiety with regard to its own status. In this article I suggest that this anxiety parallels an ontological conception of the elite as second-order in relation to the first-order mass. I use the standoff between novelist Jonathan Franzen and Oprah Winfrey in 2001 as a running (...) example of status tensions in the public sphere, arguing for a theory of vernacular as language that talks and of specialized language as language that talks about. Finally, I suggest that the separate claims to status of vernacular and specialized language might be resolved by thinking further about Bakhtin's theory of heteroglossia. (shrink)

By means of an initial examination of nineteenth century modern warfare, primarily in Italy and Germany, this article argues that, in the early twentieth century, a number of military models of attack were put in question, particularly during the First World War. Investigating the origins, development and deployment of elite troops throughout the nineteenth and twentieth centuries by way of Heidegger, amongst others, the article attempts to reveal both the continuities and the changes relating to the military techniques and (...) temporalities of elite troop offensives. It reflects on the consequences of the use of elite troops from the early twentieth century onwards and the ensuing new military order for modern warfare and for the infantry in particular. The article concludes with a historically and philosophically informed discussion of the contemporary materialization and employment of United Nations ‘rapid deployment forces’ in Bosnia and elsewhere. (shrink)

University teachers, as is well known, commit acts of despotism. About three years ago I committed such an act. I told my students that I would not accept papers which included the words protagonist, basic , alienation, total , dichotomy, and a few others including elite and elitist. On consideration I decided to remove the ban on the last two for it seemed to me that there was no other term that could be used to discuss what is, after (...) all, an interesting idea.It is of course true that my students and I use the word incorrectly. An elite must surely be a chosen body. Congress, the police, the final heat of the Miss World contest, and the Bolshevik Party are elites, whereas an aristocracy or a plutocracy—unless one believes the rich and the nobility to be chosen by God—are not. Nevertheless, when we use the word elite in connection with the visual arts it is certainly related to, though not synonymous with, class. An elite is usually a group within a relatively prosperous class. The patrons of the Renaissance were, presumably, at the apex of the social system: on the other hand, the patrons of the Impressionists belonged to a comparatively humble section of the middle classes. But it will be found that an aesthetic elite does always enjoy certain advantages of wealth and leisure and education.Quentin Bell is professor of the history and theory of art, Sussex University. He has written Virginia Woolf: A Biography, Of Human Finery, Ruskin, Victorian Artists and Bloomsbury. Other contributions to Critical Inquiry are "The Art Critic and the Art Historian" , "CRITICAL RESPONSE: Notes and Exchanges" , and "Bloomsbury and 'the Vulgar Passions'". (shrink)

In his 2002 Public Intellectuals: A Study of Decline, distinguished professor and legal theorist Richard Posner laid out for an academic audience his claim that intellectual engagement and conversation are increasingly the province of the academy and no longer torches carried by intellectual figureheads out into the public sphere. Two years later, in 2004, the best-selling Swiss writer Alain de Botton published a work of accessible nonfiction for a popular audience called Status Anxiety. In it, he argues that anxiety about (...) our status—our position in society—“possesses an exceptional capacity to inspire sorrow” (2004, ix). The two books—one from an elite academic calling fellow cognoscenti to engage the masses, the .. (shrink)

John McCormick's ‘democratic’ interpretation of Machiavelli depends on the view that Machiavelli unequivocally endorses the people's moral and political wisdom over that of princes and the elite alike. Leo Strauss's interpretation of Machiavelli offers a means for appraising the anthropological basis of this reading, which is yet to appear in the scholarship. Strauss argues that Machiavelli reduces human nature to the mere desire to stay alive. The people will therefore choose whatever political option stands to offer them the best (...) chance for survival, and, this being equivocal to them, they are just as likely to opt for democracy as they are to raise up a tyrant. From this anthropology also emerges a strand of intellectual elitism in Machiavelli, which is incompatible with what McCormick considers to be Machiavelli's staunch anti-elitism. This article therefore uses Strauss to challenge McCormick's reading of Machiavelli as a populist, arguing that McCormick exaggerates Machiavelli's populist partisanship. (shrink)

The paper deals with three interrelated Pareto’s contributions to fiscal sociology of relevant contemporary importance, i. e., the maximum of utility of the community as a sociological process (Pareto II criterion of maximum welfare), the non logical actions consisting of derivations based on residuals and the theory of the elites. Pareto II welfare criterion of sociological maximization of individual utilities is compared with Pareto I welfare criterion, commonly known as Pareto criterion, introducing the process of valuations by the elite (...) of the utilities of different social groups weighed according to their residuals. Derivations are essentials to persuade the masses to move to the points designed by the elite. The process is subject to the law of circulation of the elites which leads to different sociological equilibriums. The theories of the elites of Pareto and Mosca, criticized by Einaudi, are then compared. For a disenchanted analysis of the fiscal processes and designs, Pareto’s sociology may still provide to the economist more than a help. (shrink)

The practice of mortuary archaeology often relies upon the examination of funerary assemblages in order to reconstruct socio-cultural changes among a group of people. This paper takes a closer look at the grave goods from two pairs of Iron-Age elite Lucanian tombs at the settlement of Roccagloriosa in order to detect how funerary ideology changed over time. From the evidence I argue that there was an evolution of aristocratic gentilician identity alongside the establishment of the newly formed Lucanian ethnos (...) in Southern Italy between the fifth and fourth centuries B.C. (shrink)

The practice of mortuary archaeology often relies upon the examination of funerary assemblages in order to reconstruct socio-cultural changes among a group of people. This paper takes a closer look at the grave goods from two pairs of Iron-Age elite Lucanian tombs at the settlement of Roccagloriosa in order to detect how funerary ideology changed over time. From the evidence I argue that there was an evolution of aristocratic gentilician identity alongside the establishment of the newly formed Lucanian ethnos (...) in Southern Italy between the fifth and fourth centuries B.C. (shrink)

The aim of the present study was to explore the differences in technical performances of players considering playing positions by controlling the effect of situational variables in each FIBA female continental basketball competition. Samples of 9,208 observations from 471 games in the America, Africa, Asia, and Europe Championships during 2013–2017 were collected and analyzed by generalized mixed linear modeling. The results showed that Centers from Europe had more 2-point made, 2-point attempted, and offensive and defensive rebounds than forward. Asian and (...) European guards performed a fewer number of 2-point made, 2-point attempted, and offensive and defensive rebounds than Asian and European centers. African and Asian forward had more 2-point made, 2-point attempted than guards. This study helps to better understand the technical demands of female basketball among different international competitions, which could pave a new way to analyze the development trend of female basketball and promoting specific training plans and game strategies for coaches and players. (shrink)

Scientific collaboration can only be understood along the epistemic and cognitive grounding of scientific disciplines. New scientific discoveries in astrophysics led to a major restructuring of the elite network of astrophysics. To study the interplay of the epistemic grounding and the social network structure of a discipline, a mixed-methods approach is necessary. It combines scientometrics, quantitative network analysis and visualization tools with a qualitative network analysis approach. The centre of the international collaboration network of astrophysics is demarcated by identifying (...) the 225 most productive astrophysicists. For the years 1998–1999 and 2001–2006 four co-authorship networks are constructed comprehending each a two year period. A visualization of the longitudinal network data gives first hints on the structural development of the network. The network of 2005–2006 is analyzed in depth. Based on cohesion analysis tools for network analysis, two main cores and three smaller ones are identified. Scientists in each core and additionally in structurally interesting positions are identified and 17 qualitative expert interviews are conducted with them. The visualization of the network of 2005–2006 is used in the interviews as a stimulus for the interviewees. An analysis of the three most often used keywords of the 225 astrophysicists is included and combined with the other data. The triangulation of these approaches shows that major epistemic changes in astrophysics, e.g. the discovery of the accelerating expansion of the universe, together with technical and organizational innovations, leads to a restructuring of the network of the discipline. The importance of a combination of qualitative and quantitative network analysis tools for the understanding of the interplay of cognitive and social structure in the sociology of science is substantiated. (shrink)

In the late 1940s in Spain, a group of young scholars, most of them newly appointed university lecturers, gained control of Arbor, the promotional journal of the Consejo Superior de Investigaciones Científicas, the institution that General Franco had founded after the Spanish Civil War to organize Spanish science. This group constituted the intellectual core of the more reactionary, Catholic traditionalist faction of Franco’s regime, and they coveted greater political power, in competition with other factions of the regime. Lacking the opportunity (...) to launch an overt political campaign within a dictatorship, the group started a fight for the cultural conquest of Spain. In this cultural struggle for hegemony, journals, magazines, cultural associations, publishing houses, newspapers, and cultural centers became their weapons. By analyzing this faction’s views on and activities within the popularization of science, particularly regarding theories of evolution, this article argues that popular discourse on science played a critical role in the cultural struggle both as a “safe” channel in which to forward their claims and as a tool to gather popular attention through topics of general interest. A covert political campaign was conducted through the popularization of science and this, in turn, fueled the construction of a public sphere for science in a dictatorial context. Scientific popularization became a much-appreciated tool to achieve cultural hegemony and, as such, it also became a central element in constructing and legitimating the ideological foundations of Franco’s regime. (shrink)

Hugh Murray seems animated by two basic contentions. First, he believes that blacks and their liberal allies have acted irresponsibly by supporting the thuggish policies of the Nation of Islam and its leader, Louis Farrakhan. He states that this is “the era of Farrakhan,” and implies (without any evidence other than selected anecdotes) that support for Farrakhan among blacks is virtually unanimous. Second, he deplores the replacement in the 1960s of equal opportunity by affirmative action policies — promoted by “the (...) quota-racial-ethnic and gender preference lobby” — which he argues discriminate against more qualified individuals merely because they happen to be white or male. (shrink)

Sexuality researchers have demonstrated how the progressive campuses of selective universities shape hookups, sexual fluidity, and same-gender sex among straight-identified women. However, this research cannot fully explain a puzzling demographic pattern: women with the lowest levels of educational attainment reported the highest lifetime prevalence of same-gender sex. To make sense of this puzzle, I draw on interviews with 35 women systematically recruited from a demographic survey. I find early motherhood forecloses possibilities to develop or claim LGBTQ identities as women prioritize (...) seemingly incompatible discourses of self-sacrifice and good motherhood; sexual friendships and safety strategies provide opportunities to meaningfully explore same-gender sex and desire; and participants reject “queer” and embrace “bisexual” in the opposite pattern observed among their more privileged peers. This study underscores the situated nature of sexuality knowledge by offering an intersectional analysis of how women beyond the college hookup scene and located outside spaces permeated with LGBTQ discourses enact sexual fluidity and make meaning of same-gender sex. (shrink)